Summarised from Population mobility in Asia: Implications for HIV/AIDS action programmes, a monograph whose contents are based on manuscripts prepared and presentations made at the sub-track session, " Migrant and Mobile Populations and HIV Vulnerability", conducted as a component of the 5th International Congress on AIDS in Asia and the Pacific, Kuala Lumpur, Malaysia. October 1999. The report published was in April 2000.
For further information, contact UNDP South East Asia HIV and Development Project, United Nations Building, Rajdamnern Nok Ave, Bangkok 10200, Thailand. Tel: 66-2-288-2165 Web page: www.hivundp.apdip.net/sea.htm
These 11 papers focus on HIV vulnerability in mobile populations. They provide experiences and knowledge gained during the conduct of HIV action programmes in selected countries of the Asia region. Monitoring and evaluation of the effectiveness of HIV/AIDS programmes are included.
Looking to the future
In " Population movement, development and HIV/AIDS: Looking towards the future", authors Lee-Nah Hsu and Jacques du Guerny examine how trends in development have substantially encouraged the considerable movement of populations that may be contributing to an increase in the spread of HIV. Development and its relationship to population movement is also studied to identify potential development strategies which could inadvertently facilitate the spread of HIV and may require revision to reduce HIV vulnerability.
Their conclusions include the following:
· Development is not neutral in respect to HIV epidemics. It is essential to integrate HIV prevention strategies and programmes within development activities to achieve the maximum benefit and reduce potential costs. It is critical that development practitioners consider the development process and the impact on HIV epidemics at the planning stage of economic and social development programmes.
· A joint effort by the United Nations system to coordinate the concerns of countries in the South East Asia region can contribute to the collaborative national and regional activities.
· By the facilitation of the United Nations it is hoped that nations and organisations will be able to respond to common concerns and harmonise the necessary HIV policies and programmes to reduce HIV vulnerability reduced to mobility.
Proposed action programmes
In a paper " Proposed action programmes for the prevention of sexually-transmitted infections and AIDS among mobile populations" the author Promboon Panitchpakdi recommends an action research approach as few situations of risk among mobile populations are clearly understood. Goals of this research would include increased understanding of the needs of the target groups, increased acceptance of proposed actions, development of appropriate and suitable programmes, and testing of actions in a collaborative environment. Full understanding of the social context of the migrant worker is needed. This affects the workers behaviour patterns and includes fear, anxiety, loneliness and the lack of confidence.
The author also concludes that:
· Programme planners must eliminate pre-assumptions that relate to the needs of the population by undertaking participatory research.
· Subsequent actions are needed to recognise the specificity of all situations. Concurrently, actions are expected to include host populations in AIDS prevention activities.
STDs and risk exposure among workers in Brunei Darussalam
In a paper entitled "Sexually-transmitted infections and risk exposure among HIV positive migrant workers in Brunei Darussalam", S.K.Parida describes a screening programme carried out in 1993 to determine the prevalence of HIV among foreign workers. Brunei Darussalam has a large migrant worker population; one report showed that non-nationals formed approximately 25% of the population. The screening programme was undertaken to determine the necessary steps to be taken to reduce and prevent the spread of HIV infection in the community. Another aim was to provide counselling services to those detected as HIV positive.
The reports conclusions included:
· Most migrant workers were unaware of the risk of HIV infection during encounters with commercial sex workers and the importance of condom use at these times.
· Use of condoms requires extensive promotion and social marketing and top priority should be given to these actions in each country.
· Migrant workers wishing to migrate should undergo blood testing to determine their HIV status before leaving their home country. This will alleviate mental stress or strain on arrival.
Other papers include:
· Delayed access to health care among undocumented migrant workers in Japan. Takashi Sawada, et al.
· Social context of women migrant workers vulnerability to HIV infection in Hong Kong, China. Mridula Bandyopadhyay and Joe Thomas
· Promoting and protecting human rights to reduce the HIV vulnerability of migrant workers. Sharuna Verghis